CN105078530A - End-effector force measurement drive circuit - Google Patents

End-effector force measurement drive circuit Download PDF

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Publication number
CN105078530A
CN105078530A CN201510224776.6A CN201510224776A CN105078530A CN 105078530 A CN105078530 A CN 105078530A CN 201510224776 A CN201510224776 A CN 201510224776A CN 105078530 A CN105078530 A CN 105078530A
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CN
China
Prior art keywords
load units
jointer
drive circuit
operating theater
theater instruments
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Granted
Application number
CN201510224776.6A
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Chinese (zh)
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CN105078530B (en
Inventor
伊桑·柯林斯
约翰·赫里布
安东尼·卡尔德罗尼
约翰·潘塔齐斯
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Covidien LP
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Covidien LP
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Publication of CN105078530A publication Critical patent/CN105078530A/en
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Publication of CN105078530B publication Critical patent/CN105078530B/en
Active legal-status Critical Current
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Classifications

    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01L—MEASURING FORCE, STRESS, TORQUE, WORK, MECHANICAL POWER, MECHANICAL EFFICIENCY, OR FLUID PRESSURE
    • G01L5/00—Apparatus for, or methods of, measuring force, work, mechanical power, or torque, specially adapted for specific purposes
    • G01L5/0028—Force sensors associated with force applying means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/90—Identification means for patients or instruments, e.g. tags
    • A61B90/98—Identification means for patients or instruments, e.g. tags using electromagnetic means, e.g. transponders
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01L—MEASURING FORCE, STRESS, TORQUE, WORK, MECHANICAL POWER, MECHANICAL EFFICIENCY, OR FLUID PRESSURE
    • G01L1/00—Measuring force or stress, in general
    • G01L1/20—Measuring force or stress, in general by measuring variations in ohmic resistance of solid materials or of electrically-conductive fluids; by making use of electrokinetic cells, i.e. liquid-containing cells wherein an electrical potential is produced or varied upon the application of stress
    • G01L1/22—Measuring force or stress, in general by measuring variations in ohmic resistance of solid materials or of electrically-conductive fluids; by making use of electrokinetic cells, i.e. liquid-containing cells wherein an electrical potential is produced or varied upon the application of stress using resistance strain gauges
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Physics & Mathematics (AREA)
  • General Physics & Mathematics (AREA)
  • Electromagnetism (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Pathology (AREA)
  • Chemical & Material Sciences (AREA)
  • Analytical Chemistry (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention discloses an end-effector force measurement drive circuit. A surgical instrument for applying fasteners includes a drive motor, a replaceable loading unit having an end-effector assembly, and an adapter configured to releaseably couple a replaceable loading unit to the drive motor. The adapter includes a strain gauge having a drive circuit coupled thereto. The strain gauge and the drive circuit are configured to directly measure a driving force in the adapter.

Description

End effector power measures drive circuit
The cross reference of related application
This application claims rights and interests and priority that the serial number submitted on May 5th, 2014 is the U.S. Provisional Patent Application of 61/988,342, its whole disclosure is incorporated to the application with way of reference.
Technical field
The disclosure relates to and has reusable Handleset and the removable and operation device of plug-in package.More specifically, the disclosure relates to and being adapted at for applying the end effector Force measurement drive circuit used in the operating theater instruments of securing member.
Background technology
The powered surgical apparatus used in endoscopic procedure is known.Typically, this apparatus comprises reusable Handleset, and is sometimes referred to as single and uses the replaceable of load units or SULU and be generally disposable parts.Load units is connected to Handleset by adapter assembly, and this load units can comprise the end effector for same tissue interaction.When operation anastomat, end effector can be included in the interchangeable nail bin be replaced after operation anastomat is launched at every turn.For reducing costs and shortening the operating time, Handleset is configured to and multiple load units and/or the assembly coupling of multiple structure for using at the tissue with different qualities (such as, thickness and density) usually.Such as, different load units can have the anastomosis staple of different size and/or described anastomosis staple can be arranged to different structures.For guaranteeing that Handleset is programmed to cooperate with attached load units, some load units arrange the integrated circuit being also called chip, and described integrated circuit communicates with Handleset the structure identifying load units.This layout makes the structure of the load units when load units is attached to adapter assembly be automatically transferred between to Handleset, thus eliminates user's error or incompatibility that may experience when having and switching between heteroid load units.
Operation anastomat is often used in anastomosed tissue in body cavity, and in body cavity, end effector may contacting with fluid, such as blood, bile and/or irrigating solution.As the interconnection between fruit chip and Handleset suffers damage, then this chip may break down or may upset the data communication between load units and Handleset, and operation anastomat instability maybe can not be operated.
Sometimes the printed circuit board (PCB) (PCB) being referred to as printed substrate (PWB) or etched circuit board is widely used in and discrete electrical components is assembled into function circuit.PCB provides the not only reliable but also economic means that the signal of telecommunication is interconnected between system components usually.PCB obtains with multiple different type and classifies in many ways.
PCB is normally used for mechanical support and electrical connection electronic unit by being used in the conductive path of conducted signal on PCB or signal traces.Typical PCB comprises one or more layers insulant, and the pattern of electric conductor is formed on this insulant.Except being positioned at the conductive trace patterns on PCB, the patterned array of filling hole with metal or path can be formed to allow the inter-level interconnects between various conductive structure part.The PCB being provided with electric component is referred to as printed circuit assembly (PCA) or printed circuit-board assembly (PCBA) sometimes.
The multiple Electrosurgical device of PCB is adopted to become thin and/or compact.In some devices, the space size held needed for PCB may make the size being difficult to reduce device.In some cases, providing the PCB layout of the electric component needed for the function of expectation and/or performance can increase the overall dimension of device even as big as holding, may availability be hindered.
The signal of telecommunication can be used on PCB, follows closely to tissue delivery surgical stapling for controlling.Known for applying the operation device of anastomosis staple, clip or other securing members to tissue.Endoscopic operation device for applying surgical fasteners comprises actuating unit, that is, for the Handleset that makes device activate and the axle entered for endoscope, and be arranged in the end effector component at distal end place of described axle.Some device in these devices is designed to comprise end effector component together and the replaceable load units coupling holding anastomosis staple or securing member.This replaceable load units can comprise the anastomosis staple of various sizes, and these anastomosis staples can be arranged to one or more structures.After the anastomat being furnished with replaceable load units is launched, the load units of sky can be removed by user, select to have another load units that the anastomosis staple of identical or different size and identical or different anastomosis staple arrange and be attached to anastomat, and again launching anastomat.This process can repeat during operation technique.
During operation technique, when end effector component clamps organizationally downwards or launch time, in some cases, may not clear end effector component whether encounter one piece of cartilage, and surgeon may uncertain he whether to operate further.In some cases, when end effector component encountered hinder it to launch or motor drive have to the object overcome time, this apparatus can consume excessive electric current, and this electric current can be detected and measured.But motor current measured value possibility is also not exclusively reliable, such as when end effector component has met another identical row or run into the anastomosis staple of a succession of deformity.
Summary of the invention
According to a scheme of the present disclosure, provide a kind of operating theater instruments for applying securing member, operating theater instruments comprises CD-ROM drive motor, has the replaceable load units of end effector component and is configured to be attached to by replaceable load units releasedly the jointer of CD-ROM drive motor.Described jointer comprises the deformeter being connected with drive circuit.Deformeter and drive circuit are configured to the driving force directly measured in jointer.
According to another program of the present disclosure, the method measuring the driving force in operation device comprises: provide a kind of operating theater instruments for applying securing member, described operating theater instruments comprises the jointer being configured to releasedly the replaceable load units with end effector component is attached to CD-ROM drive motor.Described jointer comprises the deformeter being attached to the drive circuit that can detect excessive load.Described method also comprises: use deformeter and drive circuit directly to measure driving force in jointer to obtain power measured value, and if judge excessive load to be detected based on described power measured value, then driving force is regulated to cause damage to prevent docking from closing device.
According to any one in aforementioned schemes, described drive circuit comprises microprocessor, and the factory calibrated power measured value comprising slope and the offset correction factor is for good and all stored in the microprocessor of drive circuit.According to any one in aforementioned schemes, described drive circuit comprises the voltage-regulating circuit being configured to provide direct current (DC) voltage further.
Accompanying drawing explanation
When read in conjunction with the accompanying drawings, according to following detailed description, above-mentioned scheme with other of the present disclosure, characteristic sum benefit will become more obvious, wherein:
Fig. 1 be according to embodiment of the present disclosure with the axonometric chart of the surgical stapling apparatus of chip assembly coupling;
Fig. 2 is the axonometric chart of the surgical stapling apparatus of Fig. 1, it illustrates the Handleset, adapter assembly and the load units that are in separation structure;
Fig. 3 is the view of the proximal end of the load units of the surgical stapling apparatus shown in Fig. 1 and the distal end portion of adapter assembly;
Fig. 4 is the enlarged drawing of the proximal end of the load units shown in Fig. 3 and the distal end portion of adapter assembly;
Fig. 5 is another enlarged drawing of the proximal end of the load units shown in Fig. 3 and the distal end portion of adapter assembly;
Fig. 6 is proximal amplification, the exploded view of the load units shown in Fig. 3, and wherein load units is separated with certification plate;
Fig. 7 is proximal amplification, the decomposed figure of the load units shown in Fig. 3, and wherein certification plate cover is separated with load units;
Fig. 8 is the proximal enlarged drawing of the load units shown in Fig. 3;
Fig. 9 is the axonometric chart of the certification board component according to embodiment of the present disclosure;
Figure 10 is the axonometric chart of certification plate contact;
Figure 11 is amplification, the exploded view of the distal end portion of the adapter assembly shown in Fig. 3, and wherein adapter assembly is separated with jointer plate;
Figure 12 is the enlarged drawing of the jointer plate shown in Figure 11;
Figure 13 is another enlarged drawing of the jointer plate shown in Figure 11;
Figure 14 is the another enlarged drawing of the jointer plate shown in Figure 11;
Figure 15 is the cross sectional side view of the adapter assembly shown in Fig. 3, and it illustrates the adapter assembly be separated with load units;
Figure 16 is the enlarged drawing of the marked region shown in Figure 15, and it illustrates the jointer plate be separated with certification plate;
Figure 17 is the cross sectional side view of the adapter assembly shown in Fig. 3, and it illustrates the adapter assembly engaged with load units;
Figure 18 is the enlarged drawing of the marked region shown in Figure 17, and it illustrates the jointer plate engaged with certification plate;
Figure 19 is the section axial view of the adapter assembly shown in Fig. 3, and it illustrates the adapter assembly be separated with load units;
Figure 20 is the section axial view of the adapter assembly shown in Fig. 3, and it illustrates the load units be inserted in adapter assembly; And
Figure 21 is the section axial view of the adapter assembly shown in Fig. 3, and it illustrates the load units engaged with adapter assembly;
Figure 22 is the axonometric chart of the surgical stapling apparatus according to another embodiment of the present disclosure;
Figure 23 is the axonometric chart of the load units according to embodiment of the present disclosure;
Figure 24 is the load units being in the Figure 23 shown in released state with part;
Figure 25 is the detailed perspective view of board component;
Figure 26 is another detailed perspective view of the board component of Figure 25;
Figure 27 is the detailed perspective view of chip assembly;
Figure 28 is another detailed perspective view of the chip assembly of Figure 27;
Figure 29 is the detailed perspective view of the gripper shoe according to embodiment of the present disclosure;
Figure 30 is the chip assembly of Figure 25 to Figure 28 and the axonometric chart of board component;
Figure 31 is the chip assembly of Figure 25 to Figure 28 and another axonometric chart of board component;
Figure 32 is the top perspective view of the staple cartridge assembly according to embodiment of the present disclosure;
Figure 33 is the top perspective view of the staple cartridge assembly with the Figure 32 transporting wedge;
Figure 34 is the face upwarding stereogram of the transport wedge of Figure 33;
Figure 35 is the detailed perspective view of the locking assembly according to embodiment of the present disclosure;
Figure 36 is the axonometric chart of the load units of Figure 23 that staple cartridge assembly is shown;
Figure 37 is the top view after load units removes anvil block and transports wedge;
Figure 38 is the axonometric chart of the portions of proximal of the gripper shoe of staple cartridge assembly;
Figure 39 is the axonometric chart of the portions of proximal of the groove of load units;
Figure 40 is the profile of load units;
Figure 41 is the axonometric chart that part is in the chip assembly of the load units of released state;
Figure 42 is the axonometric chart of the portions of proximal of load units;
Figure 43 is the axonometric chart of chip assembly;
Figure 44 is the axonometric chart of the portions of proximal of load units;
Figure 45 is another axonometric chart of chip assembly;
Figure 46 is the detailed perspective view of the locking assembly according to embodiment of the present disclosure;
Figure 47 is another detailed perspective view of the blocking mechanism according to embodiment of the present disclosure;
Figure 48 is through the profile driving beam;
Figure 49 is another detailed perspective view of blocking mechanism;
Figure 50 is the axonometric chart that part is in released state, it illustrates locking piece, slide block and mounting portion;
Figure 51 is the axonometric chart of locking piece;
Figure 52 is the axonometric chart of the load units after removing part, it illustrates blocking mechanism;
Figure 53 is the axonometric chart that part is in the blocking mechanism of released state, it illustrates driving beam;
Figure 54 is through the profile of load units longitudinally cutting;
Figure 55 is the detail view of Figure 54 that locking piece and dynamic clamping component are shown;
Figure 56 is the side view driving beam, dynamically clamping component and slide block;
Figure 57 is the side view of driving beam, dynamically clamping component and slide block under driving beam and dynamic clamping component to be pushed into state;
Figure 58 is with the axonometric chart of the operating theater instruments for applying surgical stapling nail shown in the state of part separation, comprises the jointer being configured with deformeter and the drive circuit according to embodiment of the present disclosure;
Figure 59 is the circuit diagram of the drive circuit of Fig. 1 according to embodiment of the present disclosure;
Figure 60 is the circuit diagram that the microprocessor of Fig. 2 and the voltage-regulating circuit according to embodiment of the present disclosure are shown; And
Figure 61 illustrates the flow chart measured according to the method for the driving force in the operation device of embodiment of the present disclosure.
Detailed description of the invention
After this, describe with reference to the accompanying drawings current disclosed in comprise the operating theater instruments of the jointer being configured with deformeter and drive circuit and measure the embodiment of method of the driving force in described operation device.Identical reference number can refer to similar or identical element in the whole description of accompanying drawing.After this specific embodiment of the present disclosure is described with reference to the accompanying drawings, but, should be appreciated that the disclosed embodiments are only the examples of the present disclosure specialized in a variety of manners.Function and structure that is that know and/or that repeat is not described in detail to avoid unnecessary or unnecessary details to make the disclosure smudgy.Therefore, concrete structural and functional details disclosed herein is also interpreted as limiting, but as just the basis of claim with for instructing those skilled in the art diversely to use representative basis of the present disclosure with the detailed construction of any appropriate in fact.Just as is common in the art, term " nearside " refers to part or the parts of closer user or operator (that is, surgeon or clinician), and term " distally " refers to compared with away from the part of user or parts.In addition, as used in the specification and in the claims, the term of reference azimuth, such as " top ", " end " " on ", D score, "left", "right" etc. be with reference to the shown and accompanying drawing that describes and feature use herein.Should be appreciated that and any orientation can to implement and do not limit according to embodiment of the present disclosure.In this description and accompanying drawing, identical reference number representative can perform element that is identical, similar or identical functions.Now describe the embodiment of current disclosed chip assembly with reference to the accompanying drawings in detail, wherein, identical reference number some accompanying drawings every width figure middle finger phasing with or corresponding element.Word used herein " exemplary " is meant to " as example, example or example ".Be described as any embodiment not pattern of wants of " exemplary " herein for more preferred than other embodiments or favourable.Word " example " can use interchangeably with term " exemplary ".
This description can use phrase " in one embodiment ", " in an embodiment ", " in certain embodiments " or " in other embodiments ", and it is one or more that it all can refer to according in identical or different embodiment of the present disclosure.
As used herein, term " power source " and " power supply " refer to arbitrary electric power source, such as, and electrical socket, interchange (a/c) electromotor, battery or set of cells etc.As used in the description, " conduction " or be only that " conduction " is often referred to the generation material that can conduct electricity, includes but not limited to the material of the high conductance material of such as metal and alloy or the quasiconductor of such as semi-conducting material and semiconductor compound.As used in the description, " transmission line " is often referred to and acts as the transmission medium that meaning can be used in signal to be transmitted to from a point another point.
First see figures.1.and.2, comprise and be usually depicted as anastomat 10 according to the surgical stapling apparatus of Verification System of the present disclosure.The adapter assembly 14 that anastomat 10 comprises Handleset 12, distad extends from Handleset 12, and be optionally fixed to the load units 16 of the distal end portion of adapter assembly 14.Publication number be 2012/0089131 total U.S. Patent application provide detailed description to Handleset 12, adapter assembly 14 and load units 16, its full content is incorporated to the application with way of reference.
Handleset 12 comprises bottom housing part 17, extends and/or be supported on the middle case body 18 bottom housing part 17 from bottom housing part 17, and extends from middle housing section 18 and/or be supported on the upper housing portion 19 middle case body 18.Middle case body 18 and upper housing portion 19 are separated into distally half district 20a and nearside half district 20b, distally half district 20a and bottom housing part 17 entirety are formed and extend from bottom housing part 17, nearside half district 20b is linked by the means for attachment of any appropriate and distally half district 20a, and means for attachment is such as not limited to ultrasonic bonding and/or multiple securing member.When linking, distally half district 20a and nearside half district 20b forms handle housing 21, and handle housing 21 defining therein cavity, and this cavities contain comprises circuit board and the driving mechanism (not shown) of controller 21a.
Bottom housing part 17 comprises the door 13 be connected with its pivotable, and battery (not shown) for entering the cavity formed in bottom housing part 17, thus is retained on wherein by described door 13.Can expect, anastomat 10 can provide power by the power source of any amount, such as but not limited to, be such as fuel cell, the power line being connected to external power source etc.
Adapter assembly 14 comprises the driving coupling 22 being positioned at its proximal end place and the load units coupling 15 being positioned at its distal end portion place.The distally half district 20a of upper housing portion 19 limits the front end or the connecting portion 11 that are configured to the driving coupling 22 operationally receiving adapter assembly 14.Load units 16 comprises the jointer coupling 27 of the load units coupling 15 being configured to operationally receive adapter assembly 14.
The upper housing portion 19 of handle housing 21 encapsulates driving mechanism (not shown), and described driving mechanism is configured to driving shaft and/or geared parts (not shown) to perform the various operations of anastomat 10.Particularly, driving mechanism is configured to driving shaft and/or geared parts so that the end effector 23 of proximal body portion 24 optionally Move tool assembly or load units 16 relative to load units 16, load units 16 is rotated around longitudinal axis " X-X " (Fig. 1) relative to handle housing 21, move anvil assembly 25 relative to the nail bin groupware 26 of load units 16, and/or in the nail bin groupware 26 of load units 16, launch identical and cutting nail bin.
Load units 16 shown in Fig. 1 to Figure 21 is that linear surgical coincide load units.Described load units comprises identical anvil block, and described identical anvil block has for making surgical stapling follow closely the groove be shaped, and by the operation of load units in surgery systems, surgical stapling nail is driven against described identical anvil block.Coincide cartridge surgical stapling nail, and anastomosis staple is launched and/or driven unit.Described anastomosis staple is launched and/or driven unit is known.Be 8,256,656 and 7,044 at serial number, describe a kind of such assembly in the United States Patent (USP) of 353, therefore its full content is incorporated to the application by reference.Described driven unit comprises the elongated driving beam with blade.Described driving beam promotes the actuated slider had for the interactional wedge-shaped surface of same propeller.Described propeller support anastomosis staple and have slide block wedge-shaped surface institute against and the cam face of slip, while slide block is pushed into through identical nail bin in a longitudinal fashion, upwards drive propeller.
Can expect, this load units has the jaw members for supporting anvil block and staple cartridge respectively.Anvil block jaw members and staple cartridge jaw members can near the tissues clamped between anvil block jaw members and staple cartridge jaw members.Also can expect, end effector can do Articulating or pivotable from the longitudinal axis off-axis limited by proximal body portion 24.
Can expect, load units can be the identical unit of circular surgical stapler unit, other types, or the surgical end effector of other types, such as electric cautery, melt, ultrasound wave etc.
With reference to Fig. 3, Fig. 4 and Fig. 5, the load units coupling 15 of adapter assembly 14 is configured to via promoting and reversing or bayonet type arranges the jointer coupling 27 operationally engaging load units 16.Jointer coupling 27 comprises one or more bayonet type lug 28, described one or more bayonet type lug 28 is configured to closely cooperate with corresponding one or more bayonet type grooves 29, and described one or more bayonet type groove 29 is limited in the bayonet type lasso 48 provided by the load units coupling 15 of adapter assembly 14.Short connecting elements 44 and load connecting elements 45 to be longitudinally arranged in adapter assembly 14 and to be configured to during the operation of anastomat 10 longitudinally (such as, distad and proximad) translation.The cam 55 being arranged in the distal end portion of short connecting elements 44 is distad advanced against bayonet type groove 29 by spring 49a.For being engaged with adapter assembly 14 by load units 16, the jointer coupling 27 of load units 16 to be inserted in the load units coupling 15 of adapter assembly 14 and to be rotated.In turn, bayonet type lasso 48 rotates with jointer coupling 27 is collaborative.When bayonet type lasso 48 rotates, cam 55 diverges to from bayonet type groove 29, causes the distad translation of short connecting elements 44, and in turn, this causes switch projection 47 actuation switch 46 be formed in short connecting elements 44.Switch 46 and controller 21a operationally electrical communication be configured to pass on engagement state between load units 16 and adapter assembly 14 to described controller 21a.
Now turn to Fig. 6 to Figure 10, the jointer coupling 27 of load units 16 comprises certification board component 30, and described certification board component 30 is configured to firmly be arranged in the groove 31 that is limited in jointer coupling 27.Certification board component 30 is positioned within jointer coupling 27, make when load units 16 is fixed to adapter assembly 14, certification board component 30 engages the jointer board component 50 (Figure 11) be arranged in the load units coupling 15 of adapter assembly.More specifically, certification plate 30 comprises circuit board 37, pair of contact component 40a, 40b (overall is contact member 40) and chip 36.Circuit board 37 limits the slender member of the general planar in the groove 31 that is configured to firmly to be received in and limited by jointer coupling 27.Chip 36 and contact member 40 electrical communication.The distal end portion 37a supporting chip 36 of circuit board 37, and the proximal end 37b support contact component 40 of circuit board 37.The distal end portion 37a of circuit board 37 comprises the aligned recesses 33 be defined in wherein, the alignment fritter (alignmentnub) 32 that described aligned recesses 33 is configured to engage the correspondence of the distal end portion being arranged on groove 31 with guarantee certification board component 30 in jointer coupling 27 firmly and locate accurately.
Chip 36 comprises the detail that can store load units 16 and described detail is sent to any chip of Handleset 12, detailed such as but not limited to nail bin size, anastomosis staple layout, anastomosis staple length, clamping distance, build date, keeping life, compatibility feature, unique identifier (such as, serial number) and/or access times.In certain embodiments, chip 36 comprises EPROM (" EPROM ") chip.In this way, Handleset 12 can regulate its transmitting active force, transmitting stroke and/or other operating characteristics according to the detail of the load units 16 transmitted from chip 36.Can expect further, chip 36 can comprise permission Handleset 12 with associated embarkation unit 16 by the write capability that the chip 36 used communicates, and this can prevent loading again or the re-using of the loading assembly more exhausted, or other undelegated uses arbitrarily.
In certain embodiments, chip 36 comprises safety certification chip, the DS28E15DeepCoverSecureAuthenticator (safety certification) that what the MaximIntegratedTM such as, but not limited to San Jose manufactured have 1-WireSHA-256 and 512-BitUserEEPROM.In these embodiments, the content of chip 36 and communication between chip 36 and Handleset 12 encrypted to prevent unauthorized from entering.In this way, effectively hinder low-quality load units of poor quality, manufacture the use of load units or " stopping production " load units again, this and then the risk reduced patient by guaranteeing only to use new certified load units 16 during operation technique.In addition, the probability that armarium and/or surgeon may use load units of poor quality is unwittingly greatly reduced, because this reducing society for providing the holistic cost of medical services.In certain embodiments, chip 36 utilizes " 1-line " (1-wire) communication interface, whereby, adopts single signal conductor, and itself and earth lead are jointly for the bidirectional serial communication between chip 36 and Handleset 12.
Contact assembly 38 (Fig. 9, Figure 10) is comprised and to be linked by contact pad 59 and to have short contact point arm 41 and the long contact point arm 42 of substantially elongated U-shaped structure.Short contact point arm 41 comprises the first contact member 40a, and described first contact member 40a arranges orthogonally and is fixed to the proximal top of short contact point arm 41.Long contact point arm 42 comprises the second contact member 40b, and described second contact member 40b arranges orthogonally and is fixed to the proximal top of long contact point arm 42.Short contact point arm 41 and long contact point arm 42 is each includes solder projection 39, described solder projection 39 is arranged orthogonally and is fixed to the bottom of the distal end portion of short contact point arm 41 and long contact point arm 42.Solder projection 39 is such as linked with the proximal end 37b of circuit board 37 by welding, conductive adhesive and/or other suitable technology dynamo-electricly.
Jointer coupling 27 comprises the contact support 34 of the projection extended from the proximal end radial direction of jointer coupling 27 and comprises the pair of brackets 35a, the 35b that are limited to described support member 34, this is configured to when in the groove 31 that certification board component 30 is positioned at jointer coupling 27, receive the first contact member 40a and the second contact member 40b respectively to support 35a, 35b.Lid 43 is configured to certification board component 30 to encapsulate and is retained in the groove 31 of jointer coupling 27 (Fig. 7 and Fig. 8).
In certain embodiments, short contact point arm 41 and the first contact member 40a are by contact pad 59 and long contact point arm 42 and the second contact member 40b electric insulation.In these embodiments, each carrying circuit separately in short contact point arm 41 and long contact point arm 42, such as, short contact point arm 41 carrying signal line and long contact point arm 42 carries ground wire.In other embodiments, short contact point arm 41 and the first contact member 40a are with long contact point arm 42 and the second contact member 40b electrical connection.In these embodiments, short contact point arm 41 and long contact point arm 42 run with bifurcated or redundant mode with carrying signal circuit, and grounded circuit is carried by other conductive components of load units 16, jointer unit 14 and/or Handleset 12 simultaneously.
As mentioned above, when load units 16 is fixed to adapter assembly 14, certification board component 30 is configured to engage the jointer board component 50 be arranged in load units coupling 15.Referring now to Figure 11 to Figure 14, load units coupling 15 comprises jointer board component 50, and described jointer board component 50 is configured to floating ground and is arranged in the depression 60 that is defined in load units coupling 15.Jointer board component 50 is positioned in load units coupling 15, and make when load units 16 is fixed to adapter assembly 14, jointer board component 50 engages certification board component 30.
Jointer board component 50 comprises circuit board 51, and described circuit board 51 has and is fixed to pair of contact component 55a, 55b on it (overall is contact member 55) and is operationally communicated with Handleset 12.In an illustrated embodiment, contact member 55a, 55b are arranged to for effective joint in a lateral direction, and such as, transverse to the longitudinal axis " X-X " of anastomat 10, thus the rotation adapting to load units 16 as described herein and adapter assembly 14 connects.
Circuit board 51 comprises upper surface 51a, lower surface 51b, proximal end 51c and distal end portion 51d.Circuit board 51 limits the slender member of general planar, and the slender member of described general planar is configured to flexibly or floating ground is contained in the depression 60 that limited by load units coupling 15.Alligator clamp 52 is fixed to the proximal end 51c of circuit board 51 and is configured at depression 60 inner support jointer board component 50.Alligator clamp 52 comprises a pair spring support 54 with wing structure, and this is configured to prevent alligator clamp 52 excessively extension to spring support 54 and provides rigidity for alligator clamp 52.Jointer board component 50 comprises and has broad bending u shape profile, the spring 53 be arranged on the upper surface 51a of circuit board 51.In certain embodiments, alligator clamp 52 and spring 53 can overallly be formed.Alligator clamp 52 and/or spring 53 positively can align and/or be supported by the recess 62 be limited in the proximal end 51c of circuit board 51.Circuit board 51 comprises and is defined in one or more through hole 56, and described through hole 56 can be used to form conductive path between the upper surface 51a and lower surface 51b of circuit board 51.
When jointer board component 50 is arranged in depression 60, spring 53 abuts against the outer tube 57 (Figure 15, Figure 16) supporting adapter assembly 14.In use, jointer plate 50 is biased towards certification board component 30 spring by the alligator clamp 52 of spring 53 and side, make when engaging load units 16 and adapter assembly 14, any manufacturing tolerance between load units 16 and adapter assembly 14 is able to by the joint of the spring(-supported) mount floated of the jointer plate 50 in depression 60 and compensates.In this way, be able to realize being connected reliably all the time between the contact member 55 and the contact member 40 of certification board component 30 of jointer plate 50, therefore between chip 36 and Handleset 12, provide firm communication link.In an embodiment, contact assembly 38, contact 40 and/or contact 55 are made up of conductive material, at least in part such as, but not limited to beryllium copper.
Now turn to Figure 15 to Figure 21, show the interaction between jointer board component 50 and certification board component 30.As seen in Figure 15, Figure 16 and Figure 19, jointer plate 50 is retained in load units jointer 15 by alligator clamp 52.Spring 53 abuts against and supports outer tube 57 to be inwardly biased towards hole 61 by jointer plate 50, and contact member 55 is extended in hole 61.Along with jointer coupling 27 is fully inserted in the hole 61 of load units jointer 15, jointer coupling 27 makes the contact member 40 of certification plate 30 and contact member 55 roughly 45 °, the interval (Figure 20) of jointer plate 50 with the original rotative orientation of load units coupling 15.Rotate load units 16 along with relative to adapter assembly 14, the contact member 40 of certification plate 30 reaches and engages with the contact member 55 of jointer plate 50.Advantageously, when contact member 30 engages with the contact member 55 of jointer plate 50 joined together, the contact support 34 of the jointer coupling 27 of load units 16 provides radial support for contact member 30.In addition, spring 53 abuts against and supports outer tube 57, and this makes jointer plate 50 can float relative to certification plate 30 and device unit coupling 15, thus the manufacturing variation compensated between various parts provide reliable connection between certification plate 30 and jointer plate 50.
Can expect, the load units similar with load units 16 can have removable and interchangeable staple cartridge assembly.According to embodiment of the present disclosure, anastomosis system has been shown in Figure 22 to Figure 57, described anastomosis system has with the similar power handle assembly 112 of Handleset 12 discussed above.Described Handleset carries out constructing and having controller 121a as discussed above.Anastomosis system comprises adapter assembly 114 and load units 116, and each in adapter assembly 114 and load units 116 can construct as discussed above.Load units is that straight line coincide load units, but can expect the load units of other types.As discussed above, load units 116 has the driven unit for being transmitted into by anastomosis staple in the tissue that is clipped between anvil block jaw members 111 and staple cartridge jaw members 113.
Be supported in staple cartridge jaw members 113 is removable and interchangeable staple cartridge assembly 115.Be that the serial number submitted on October 25th, 2011 is 13/280,880, and as disclosing a kind of removable and interchangeable staple cartridge assembly in U.S. Patent application disclosed in US2013-0098965A1, its whole disclosure is incorporated to the application with way of reference.。
Load units 116 of the present disclosure is configured to use once.Especially, load units has the removable staple cartridge assembly 115 comprising staple cartridge discussed above and driven unit.This removable assembly 116 is configured to be removed and be replaced (such as, after launching anastomosis staple or other surgical fasteners from it).Shown load units 116 comprises the proximal body portion 118 that can be attached to adapter assembly 114.But the feature of load units of the present disclosure can be merged in the operating theater instruments of the removable section of the elongated portion not comprising apparatus.
Load units 500 comprises the proximal body portion 118 limiting longitudinal axis " A-A ".Jaw members comprises anvil block jaw members 111 and nail bin jaw members 113.One in jaw members can relative to another pivotable to make clamp tissue between jaw members.In an illustrated embodiment, nail bin jaw members 113 can be opened or removable between non-clamped position and closed or approximated position relative to anvil block jaw members pivotable.But anvil block jaw members can be moveable, or nail bin jaw members and anvil block jaw members can be both moveable.Discuss as composition graphs 1 to Figure 21, anvil block jaw members comprises the anvil block with multiple anastomosis staple shaped depression portions.
Nail bin jaw members 113 comprises receives and supports groove or the bearing part 120 of staple cartridge assembly 115.Nail bin groupware has nail bin main body 140 and gripper shoe 111.Nail bin main body and gripper shoe are connected (as discussed below), retainer, locking piece by snap fit or are attached to groove or bearing part 120 by the connection of another kind of type.Nail bin groupware comprises securing member or anastomosis staple 141.Nail bin main body 140 limits the multiple spaced anastomosis staple fixing slit 142 (see Figure 32) being constructed to opening.Each slot configuration becomes securing member or anastomosis staple to be received in wherein.Nail bin groupware also limits multiple cam wedge slit, and described multiple cam wedge slit holds anastomosis staple propeller 146 and is open to allow actuated slider 148 when as discussed previously at transmitting anastomosis staple longitudinally through wherein in bottom.
Removable staple cartridge assembly 115 comprises nail bin main body 140 and gripper shoe 111.Removable assembly 115 is removable from groove 120, such as, after anastomosis staple is launched from nail bin main body 140.Another removable and interchangeable staple cartridge assembly can be loaded in groove, makes load units 116 again can activate thus launch extra securing member or anastomosis staple.
Groove 120 comprises for of engaging staple cartridge assembly and gripper shoe or pair of engaging structure 120a (such as slit) (see Figure 39), for for the central slot driving beam to pass through, for being connected a pair proximal aperture 150 and the ramp surface 152 of anvil block jaw members.Proximal aperture 150 is configured to the hole corresponding with a pair in anvil block jaw members or feature aligns/mechanically engage.Jaw members such as connects by pin to be conducive to the pivoting relationship between anvil block jaw members 111 and nail bin jaw members 113.
Nail bin main body 140 comprises central slot 143 and is positioned at many rows anastomosis staple fixing slit (see Figure 32) on every side of slit 143.It is protruding that nail bin main body also comprises pair of engaging structure or a pair, in certain embodiments, and described pair of engaging structure or can be for a pair proximal slit or the opening of contiguous nail bin main body for being connected with gripper shoe 111a and/or raceway groove 120.
Concrete with reference to Figure 29, gripper shoe 111a comprises pedestal 145, for the engagement features 147 that is connected with nail bin main body and/or groove and 147a (see Figure 38), and be positioned at the installation portion 149 (see Figure 29) at proximal end place of gripper shoe 111a.Gripper shoe 111a is arranged in below nail bin main body to support anastomosis staple propeller, actuated slider and anastomosis staple (or other surgical fasteners) and to prevent these parts from dropping from staple cartridge assembly.
Such as, as shown in Figure 41 to Figure 45, load units can comprise the chip assembly 360 in the proximal end being arranged on proximal body portion 118.Described chip assembly combines with above-mentioned certification board component 30 as discussed above.Chip assembly 360 for connecting the board component of the coupling on the distal end portion being arranged in adapter assembly 114, and can as composition graphs 1 to Figure 21 above construct with discussing.Chip assembly 360 comprises the chip 361 for certification and information object, and can comprise the memorizer storing some information.This information can comprise the type of device of this load units, the version of device/load units, load units title, product batch number, serial number or other identification numbers, the maximum, force of the driving beam of load units, interlock region (mm), end region (mm), load units can be driven can to do Articulating and/or use restriction (number of times that load units can use).Interlock region is when driving beam when being blocked part in load units and engaging from driving beam or the position of driving beam that initial position measures with millimeter.End region is when driving beam when having arrived its end of travel in staple cartridge main body 140 from driving beam or the position of driving beam that initial position measures with millimeter.Because this staple cartridge assembly 115 can be removed and be replaced, then there is the restriction of having a mind to again can loading the number of times of the new staple cartridge of not launching to load units.The information be stored on chip can comprise the coincide length of row and/or the length of nail bin.
Controller 121a in Handleset 112 can be programmed to read the information on chip 361.This information uses in the operation of surgery systems.It is desirable that, to some or all information encryptions, this can as above having come of discussing of composition graphs 1 to Figure 21.When serial number or other data can not be identified, controller can be programmed to not provide power to the motor (not shown) be arranged in Handleset 112, and does not make adapter assembly and load units run.Maximum, force information combines the load cell be arranged in surgery systems and uses, and this load cell is such as deformeter.Such as, load cell can be arranged in adapter assembly 114 and/or load units, is such as positioned at the load cell driven on beam.Controller can be programmed to the data from load cell to compare, such as to interrupt the running of motor (not shown) before exceeding maximum, force with the maximum, force data be stored on chip.In another example, if the power that controller can be programmed to measure reaches predeterminated level, run with " low-speed mode ".The predeterminated level of power can be maximum, force discussed above, or stores the power of another level on chip (such as chip 361) in systems in which.Low-speed mode means that controller makes motor (not shown) with comparatively low rate operation, so produces more moment of torsion and postpones the extruding of tissue and/or the transmitting of anastomosis staple simultaneously.In thick tissue, low-speed mode can allow the liquid in tissue to leave anastomotic position, is conducive to extrusion tissue more.
By similar mode, if drive beam to be arranged in interlock region or end region, then can stop the operation of motor or motor is run with low-speed mode.In addition, do not carry out Articulating as the data on fruit chip 361 indicate load units, then controller can interrupt or prevent the operation of Articulating STATEMENT OF FEDERALLY SPONSORED, bar or cable.
Can expect, the chip 361 with some or all in data discussed above can be arranged in any embodiment disclosed herein, comprises the load units without removable and replaceable staple cartridge assembly and/or the load units that can not do Articulating.
Can expect, the information on chip 361 can be read by the controller in Handleset, another chip in system or any other the machine element in surgery systems.
In any embodiment disclosed herein, information can be write in the chip on load units by controller.Such as, as measured by load cell discussed above in order to be clamped to structural maximum, force, in order to launch the maximum, force of anastomosis staple and/or to drive beam to drive the position of beam when stopping advancing, etc.Whether the number of times that other information that can be written on chip 361 comprise the driving position of beam when device enters into low-speed mode, load units has been launched, load units are launched, the serial number of the type of Handleset, the serial number of Handleset, the type of adapter assembly and/or adapter assembly.In any embodiment disclosed herein, the maximum, force of launching anastomosis staple can be saved together with driving the position of beam.Information can also be kept in other chips in the memorizer of the controller be connected in Handleset, in system or in other machine elements of this surgery systems.
Also can expect, in any embodiment disclosed herein, end effector or tool assembly are arranged to do Articulating between the second position that the primary importance of aliging at the same longitudinal axis of tool assembly " Y-Y " and tool assembly arrange at an angle relative to longitudinal axis " Y-Y ".Such as, the tool assembly comprising anvil block jaw members and nail bin jaw members can be mounted for can relative to proximal body portion 118 pivotable.Anvil block jaw members and nail bin jaw members can be attached to installation component 2020 (discussing further) below, and installation component can be connected to proximal body portion 118 pivotly.Load units 116 comprises and is arranged in one or more cable in proximal body portion or STATEMENT OF FEDERALLY SPONSORED, and during with convenient cable or STATEMENT OF FEDERALLY SPONSORED displacement, tool assembly is relative to apparatus pivotable and do Articulating.Authorizing the people's such as Milliman have the 6th, 953, describe the further details providing Articulating in No. 139 United States Patent (USP)s in detail, its whole disclosure is incorporated to the application with way of reference.Adapter assembly 114 can comprise the STATEMENT OF FEDERALLY SPONSORED of the Articulating for implementation tool assembly, bar or cable.
As shown in Figure 32, such as, any embodiment disclosed herein can comprise the nail bin main body 140 with staged tissue contacting surface 1412.In such an embodiment, the anastomosis staple of the anastomosis staple of different size or whole same size can be used.The further details with the staple cartridge of multiple staple dimension is included in authorizes the people's such as Holsten the 7th, 407, and in No. 075 United States Patent (USP), its full content is incorporated to the application with way of reference.The anastomosis staple forming pockets of anvil block or anastomosis staple propeller or the shape and size that both can therefore be configured to expect make anastomosis staple be shaped.
Removable and interchangeable staple cartridge assembly 115 can comprise chip assembly 362 (see Figure 27 and Figure 28) further.Corresponding board component 380 (Figure 25 and Figure 26) is arranged on the tool assembly of load units 116, and can be arranged on groove 120.Tool assembly board component 380 can construct as discussed previously together with the jointer board component 50 of jointer coupling 27.Tool assembly board component 380 is configured to be firmly installed on the wall of groove 120.When this board component 380 is located and is fixed to the groove 120 of load units with convenient nail bin groupware 140, chip assembly 362 engages the board component 380 (see Figure 29 to Figure 31) be arranged on groove.Figure 27 and Figure 28 shows the relation between chip assembly and staple cartridge main body 140, and Figure 29 shows the relation between chip assembly 362 and gripper shoe 111a.
In more detail, chip assembly comprises main body 337 and is connected to pair of contact component 340a, the 340b (overall is contact member 340) of the chip 336 be arranged in main body.Main body 337 limits the rectangular elements with flexible arm, described flexible arm has hasp feature 337a.Flexible arm is configured to firmly be received in the groove 331 that is limited in nail bin main body.Chip 336 and contact member 340 electric connection.
Chip 336 comprises any chip of the information that can store about staple cartridge assembly 115.Chip can be identical or similar with the chip of certification board component 30.In any embodiment disclosed herein, any chip all can store information, arrange length (or length of nail bin), build date, keeping life, compatibility feature, unique identifier (such as, serial number) and/or access times such as, but not limited to nail bin size, anastomosis staple layout, anastomosis staple and whether used staple cartridge assembly.This information can be sent to controller in Handleset 112 or another machine element by suitable bus, pin connector, wireless device etc.In certain embodiments, chip 336 comprises EPROM (" EPROM ") chip.Information can be write on chip 336 by the controller in Handleset.In this way, according to the information about staple cartridge assembly sent from chip 336, its emissivity of Handleset 112 scalable, transmitting stroke and/or other operating characteristics.To chip 336 communication, Handleset 112 can show that staple cartridge assembly is used, can prevent the loading again of the loading assembly more exhausted like this or reuse or the use of any other unauthorized.The information be stored in any parts in surgery systems can adopt private key, public keys and/or SHA to be encrypted.
Board component 380 also has pair of contact 380a and 380b and main body 381.This board component is mounted for contacting with chip assembly 362 when staple cartridge assembly is properly installed in groove 120.The L shape that contact 380a, 380b, 340a and 340b have as seen in the drawings constructs so that they can flexibly engage mutually.Main body 381 can limit snap features part 382, and described snap features part 382 is configured to hole 383 in engaged groove thus firmly installing plate assembly.Board component is properly connected to bus, wire or has wireless communicator or any other computer installation for information to be sent to the controller Handleset from chip assembly 362.
In any embodiment disclosed herein, blocking mechanism 500 is arranged in load units.Load units can construct as discussed above.In addition, the disclosure relates to the removable assembly with latching member, or has the load units of latching member.
Blocking mechanism 500 comprises locking piece 2010 and at least one spring 2030, and be configured to the transmitting again preventing staple cartridge assembly 115 or staple cartridge 26, and also prevent after launching staple cartridge and load the front wheel driving beam distad translation of another nail bin groupware 115.Blocking mechanism 500 be shown as with the slide block 148 in Figure 50 and installation component 2020 side by side.At least one spring 2030 is arranged on surface 2031 distally.Such as, groove is formed in surface 2031 for receiving spring 2030.Corresponding pillar be arranged on locking piece 2010 towards on the surface of nearside.Locking piece is configured in load units can pivotable, and comprises at least one prong 2012, rear portion 2014 and support portion 2016.Locking piece is configured to around support portion 2016 pivotable, is illustrated, and is biased by single or multiple spring 2030 in Figure 50 and Figure 51 as two sagging down features.Slide block 148 has hole or groove for receiving at least one prong 2012 when locking piece and driving beam are in their initial position (see Figure 52).Drive beam 2039 to work in coordination with dynamic clamping component 2040 or to comprise dynamic clamping component 2040, described dynamic clamping component 2040 has upper flange 2042, lower flange 2044 and blade 2046 (see Figure 53).
On initial position, locking piece 2010 is biased along direction forward or distad, and contacted the edge 2039a driven on beam 2039 by rear portion 2014, what prevent locking piece further rotates motion.Along with driving beam and dynamic clamping component move up in side forward or distad, dynamic clamping component distad promotes slide block.The rear portion 148a of slide block promotes single or multiple prong 2012, makes locking piece overcome the biased of at least one spring 2030 and tilt.Like this by the removal from areas of rear portion 2014 from the 2039a that keeps to the side, and allow to drive beam and dynamic clamping component to move forward.At dynamic clamping component after locking piece 2010, locking piece rotates (see Figure 57) forward under the influence of the spring.
At dynamic clamping component and slide block by anastomosis staple from after nail bin 140 is launched, dynamic clamping component proximad moves, and slide block is stayed the distal end portion place of nail bin 140 and nail bin groupware 115.Along with locking piece is shifted out travel path (see Figure 57) by cam face 2041, dynamic clamping component can move by locking piece 2010.Once dynamically clamping component turns back to initial position, then another of anti-dynamic clamping component 2040 moves forward by locking piece 2010.Locking piece rear portion 2014 is in the position (see Figure 57) of another edge 2039b of engages drive beam.If load units accepts the removable and type of interchangeable staple cartridge assembly 115, then nail bin groupware 115 can be configured to make locking piece 2010 turn back to initial position, to drive beam and dynamic clamping component again distad mobilely can organize anastomosis staple to launch another.
As discussed above, any embodiment disclosed herein can comprise the chip assembly 360 be positioned on surgical stapling load units, as the load units 116 of the information of the blocking mechanism had about all blocking mechanisms described above.In addition, relevant with blocking mechanism information can be stored on chip 361.Such as, the fact that blocking mechanism engages can be recorded in by the controller in handle in chip assembly 360 and/or chip assembly 362.Controller in handle can comprise memorizer (comprising processor) for storing information and other machine elements.Controller also can comprise galvanometer or ammeter, to measure the electric current in the motor of Handleset.Controller can be programmed to be recorded in the peak point current reached between the operating period of load units and/or staple cartridge assembly, and can the peak point current of any chip in recording system or other machine elements.The peak point current reached after launching anastomosis staple can indicate, before new staple cartridge assembly is arranged in load units, attempt Secondary Emission load units.Alternatively, blocking mechanism can comprise sensor, such as, is arranged on the sensor on locking piece.Can expect, this surgery systems can comprise the load units of the blocking mechanism without similar the sensor mechanism.The fact that load units does not have blocking mechanism can be stored in chip 361.
Handleset can also comprise encoder, described encoder determination motor output shaft has completed how many times and has rotated, this can be used in the position of the drive rod, STATEMENT OF FEDERALLY SPONSORED, cable etc. determined in adapter assembly, the driving beam in load units or launch the position of bar or the position of miscellaneous part.Alternatively, other sensors can be used to determine the position of the various parts in surgery systems.
In any embodiment disclosed herein, adapter assembly disclosed herein can as being that carrying out disclosed in U.S.'s published application of 2011/0174099A1 constructs in publication No., and its whole disclosure is incorporated to the application with way of reference.Motor in Handleset provides rotation to export on the rotary shaft and jointer is configured to change this output into linearly moving STATEMENT OF FEDERALLY SPONSORED or bar, and can provide driving to the Articulating STATEMENT OF FEDERALLY SPONSORED in the proximal body portion 118 of load units 116.Handleset and/or adapter assembly can as in publication No. be 2014/0012289A1 and 2014/0110453A1 U.S. published patent application in disclosed carrying out construct, its whole disclosure is incorporated to the application with way of reference.
Power is measured and drive circuit
Any embodiment disclosed herein can comprise power and measure and drive circuit, or can be configured to and have power and measure and the parts coupling of drive circuit.Operating theater instruments for applying securing member is known, and wherein, the power be applied in end effector component by motor drive mechanism is estimated by motor current measured value.But, the error source along with temperature change may be there is in this measurement scheme, and there is uncertainty due to the combination of an end effector component and jointer and the difference of the frictional force between another end effector component and the combination of jointer, this means that the power by means of only motor current estimation is variable in their reliability.
Various embodiment of the present disclosure provides a kind of operating theater instruments comprising jointer, and described jointer is configured to end effector component to be operationally attached to motor drive mechanism and is configured to the driving force directly measured in jointer.Current disclosed operating theater instruments embodiment can detect excessive load and/or prevent from causing damage to jointer and/or Handleset, can promote reliability like this.The various embodiments of current disclosed operating theater instruments can also collect the data relevant to Tissue approximation.Current disclosed operating theater instruments embodiment is configured to determine when that reaching tissue ends stops or end stop condition exactly.
The various embodiments of current disclosed operating theater instruments utilize the jointer being configured with deformeter and drive circuit.Although following description describes the use of deformeter, the various sensing apparatus that instruction of the present disclosure is also applicable to provide the electric signal proportional with institute applied pressure to export.In certain embodiments, drive circuit comprises special instrumentation amplifier, tuning 2 pole filters of customization, low-power mode switch, 12 analogue-to-digital converters and 32-bit microprocessor.Although following description describes the use of the operating theater instruments for applying surgical stapling nail, instruction of the present disclosure also can be applicable to the various operation devices comprising end effector and axle, such as, and the device of seal tissue.
Figure 58 shows at various operation technique (such as, endoscopic surgery operates) the middle operating theater instruments 1110 used, and comprise groups of motors 1150, set of cells 1160, jointer 1120 and there is the replaceable load units 1114 being configured to the end effector component 1111 applying anastomosis staple.Replaceable load units 1114 and/or end effector component 1111 can comprise the anastomosis staple of various sizes and these anastomosis staples can be arranged to one or more structures.In certain embodiments, replaceable unit unit 1114 is configured to the distal end portion being attached to jointer 1120 releasedly.
As shown in Figure 58, operating theater instruments 1110 comprises the plastic uptake shell (clamshell) 1140 being configured to keep groups of motors 1150 and set of cells 1160, and comprises the coupling mechanism 1130 for operationally jointer 1120 to be attached to groups of motors 1150 via plastic uptake shell 1140.Operating theater instruments 1110 additionally or alternatively can comprise Handleset (not shown), and wherein, jointer 1120 extends from the distal end portion of Handleset.In certain embodiments, apparatus 1110 can be provided with the transmission line (not shown) for apparatus 1110 being connected to external power source.
According to embodiment of the present disclosure, use deformeter 1122 or other force transducers and directly in jointer 1120, measure driving force with its drive circuit 1129 operationally associated.The embodiment of current disclosed operating theater instruments 1110 can comprise power measured value after factory calibrated, whereby, slope and the offset correction factor are for good and all stored in the microprocessor (microprocessor 1240 such as, shown in Figure 59 and Figure 60) of drive circuit 1129.In this way, jointer 1120 can exchange between different Handleset or plastic uptake shell 1140, and power measured value after ensure that calibration.In certain embodiments, after the calibration of the end of stroke, power measured value will raise, and contribute to realizing reliable end like this and stop detecting.
Force transducer and force cell (forcetransducer) can show the drift of skew along with temperature and time.According to embodiment of the present disclosure, force cell is calibrated during manufacture in the factory.This calibration to microprocessor (such as, microprocessor 1240 shown in Figure 59 and Figure 60) provide modifying factor for being made the realistic function power applied during factory manufactures from the data that sensor (such as, deformeter 1122) receives with coupling for amendment by microprocessor.In an exemplary embodiment, first this calibration needs the measured value of sensor offset " Y1 ".Next, known force " F1 " is applied to sensor, and the output of measuring transducer provides data point " Y2 ".Apparent slope " Sapp " can adopt equation Sapp=(Y2-Y1)/F1 to calculate.
Skew " Y1 " can be stored in microprocessor 1240 (and/or being stored in the memorizer that operationally associates with microprocessor 1240), and micro-process 1240 can be configured to deduct skew " Y1 " from all data received by sensor.This represent and revise for " b " from the straight line using the sensor expection of y=mx+b equation.Gradient correction calculates by first " Sapp " being compared with ideal value " Si ", and described ideal value " Si " is that the ideal with the system that power " F1 " inputs exports.Term " m " in y=mx+b equation is revised by ratio Si/Sapp.
In Figure 59 and Figure 60, show the circuit diagram of drive circuit 1129 (Figure 58), and it comprises instrumentation amplifier 1220, microprocessor 1240, operational amplifier or " op-amp " 1230 and is connected to the interface 1215 of deformeter 1122 and provides the electric power on/off circuit 1210 of ON/OFF ability.As shown in Figure 60, drive circuit 1129 comprises voltage-regulating circuit 1250 further, and it provides pure D/C voltage.In certain embodiments, voltage-regulating circuit 1250 provides the D/C voltage of 3.3 volts.
Instrumentation amplifier 1220 is selected for power supply injection ratio (powersupplyinjectionratio) and no current consumption.Instrumentation amplifier 1220 is designed to strengthen the relatively noisy signal from deformeter or very faint signal, such as, signal is strengthened about 50 times.Op-amp1230 has low-power consumption and small size usually, and the signal from amplifier 1220 can be configured to strengthen about 10 times.In certain embodiments, op-amp1230 provides the gain of the 20dB of the cut-off frequency with 20Hz, and can be the two poles of the earth Butterworth filter (twopoleButterworthfilter).Op-amp1230 also can provide low-pass filtering, such as to resist motor noise, and/or electromagnetic interference (EMI) can be provided to suppress.The analog to digital that the modulating output of op-amp1230 is sent to microprocessor 1240 via conductor 231 inputs and is transformed into digital form.Due to the space constraint for holding drive circuit 1129 within jointer 1120, the main consideration selecting op-amp1230 and microprocessor 1240 is small size.
After this, with reference to Figure 61, the method according to the driving force in measurement operation device of the present disclosure is described.Should be appreciated that step provided in this article can merge when not departing from the scope of the present disclosure to perform or perform to be different from the order occurred herein.
Figure 61 is the flow chart of the method illustrated according to the driving force in the measurement operation device of embodiment of the present disclosure.In step 1410, operating theater instruments 1110 is set up and comprises the jointer 1120 being configured to releasedly the replaceable load units 1114 with end effector component 1111 is attached to CD-ROM drive motor 1150.Jointer 1120 comprises the deformeter 1122 being attached to the drive circuit 29 that can detect excessive load.In certain embodiments, end effector component is configured to apply anastomosis staple.
In certain embodiments, drive circuit 1129 comprises microprocessor 1240 and op-amp1230.Op-amp1230 can be configured to provide low-pass filtering and/or can be the two poles of the earth Butterworth wave filter.In certain embodiments, the method shown in Figure 61 can comprise the analog to digital input modulating output of op-amp1230 being sent to microprocessor 1240 further.Drive circuit 1129 can comprise the voltage-regulating circuit 1250 of the D/C voltage that can provide 3.3V further.
In step 1420, deformeter 1122 and drive circuit 1129 are used to directly to measure driving force in jointer 1120 to obtain power measured value.
In step 1430, excessive load detected if determined based on power measured value, then regulate driving force to cause damage to prevent docking from closing device 1120.
In certain embodiments, the method shown in Figure 61 can comprise further: use end effector component and/or utilize end effector component 1111 to apply anastomosis staple in endoscopic surgery operation.
Above-mentioned operating theater instruments and the method for driving force measured in operation device are applicable to and utilize in endoscopic surgery operation and/or be applicable to utilize in open operation application.
Any embodiment described by any composition graphs 1 to Figure 57 can comprise deformeter discussed above (or other force transducers) and/or drive circuit.In any embodiment disclosed herein, the motor in Handleset or plastic uptake shell can be the motor being configured to activate one or more driver (such as rotatable driving connector).Motor is connected to battery, and battery can be DC battery (such as, rechargeable lead base battery, nickel radical battery, lithium ion based battery etc.), AC/DC transformator or is applicable to provide to motor any other power supply of electric energy.
Although describe embodiment for schematic and descriptive object in detail with reference to accompanying drawing, should be appreciated that therefore disclosed process and device are not interpreted as restriction.Such as, deformeter or other force transducers can be arranged on the miscellaneous part on driving beam, on dynamic clamping component, on clamp or in surgery systems.It will be obvious to those skilled in the art that and can carry out various amendment to previous embodiment when not departing from the scope of the present disclosure.

Claims (19)

1., for applying an operating theater instruments for securing member, comprising:
CD-ROM drive motor;
Replaceable load units, it has end effector component; And
Jointer, it is configured to releasedly described replaceable load units is attached to described CD-ROM drive motor, described jointer comprises the deformeter being connected with drive circuit, and wherein, described deformeter and described drive circuit are configured to the driving force directly measured in described jointer.
2. operating theater instruments according to claim 1, wherein, described drive circuit comprises microprocessor and operational amplifier.
3. operating theater instruments according to claim 2, wherein, described operational amplifier is configured to provide low-pass filtering.
4. operating theater instruments according to claim 3, wherein, described operational amplifier is the two poles of the earth Butterworth filters.
5. operating theater instruments according to claim 2, wherein, described operational amplifier is configured to provide electromagnetic interference to suppress.
6. operating theater instruments according to claim 2, wherein, the factory calibrated power measured value comprising slope and the offset correction factor is for good and all stored in described microprocessor.
7. operating theater instruments according to claim 2, wherein, described drive circuit comprises the voltage-regulating circuit being configured to the DC voltage providing 3.3 volts further.
8. operating theater instruments according to claim 2, comprises the conductor of the analog to digital input being configured to the modulating output of described operational amplifier is sent to described microprocessor further.
9. operating theater instruments according to claim 1, wherein, described end effector component is configured to apply anastomosis staple to tissue.
10. operating theater instruments according to claim 9, wherein, described end effector component is configured for using in endoscopic surgery operation.
11. 1 kinds for measuring the method for the driving force in operation device, described method comprises:
Be provided for the operating theater instruments applying securing member, described operating theater instruments comprises the jointer being configured to releasedly the replaceable load units with end effector component is attached to CD-ROM drive motor, described jointer comprises deformeter, and described deformeter is attached to the drive circuit that can detect excessive load; And
Described deformeter and described drive circuit is used directly to measure driving force in described jointer to obtain power measured value.
12. methods according to claim 11, comprise further:
If determine based on described power measured value and excessive load detected, then regulate described driving force to prevent from causing damage to described jointer.
13. methods according to claim 11, comprise further:
The operational amplifier of described drive circuit is adopted to perform low-pass filtering to signal.
14. methods according to claim 13, comprise further:
The modulating output of described operational amplifier is sent to the analog to digital input of the microprocessor of described drive circuit.
15. methods according to claim 11, comprise further:
Use described end effector component to apply anastomosis staple.
16. methods according to claim 15, comprise further:
Described end effector component is used in endoscopic surgery operation.
17. methods according to claim 11, comprise further:
Use the voltage-regulating circuit of described drive circuit to provide the DC voltage of 3.3 volts.
18. methods according to claim 11, comprise application slope and the offset correction factor further.
19. methods according to claim 18, wherein, described slope and the offset correction factor are for good and all stored in described microprocessor.
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